Plavix

Generic Name: clopidogrel (kloe PID oh grel)
Brand Names: Plavix

What is clopidogrel?

Clopidogrel keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.

Clopidogrel is used to prevent blood clots after a recent heart attack or stroke, and in people with certain disorders of the heart or blood vessels.

Clopidogrel may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about clopidogrel?

Clopidogrel keeps your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions. Because of this drug action, clopidogrel can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of bleeding in your digestive tract. Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using clopidogrel. You may need to stop using the medicine for at least 5 days before having surgery, to prevent excessive bleeding. Follow your doctor's instructions and start taking clopidogrel again as soon as possible. While you are taking clopidogrel, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

Tell your doctor about all other medicines you use to prevent blood clots.

What should I discuss with my healthcare provider before taking clopidogrel?

Do not use this medication if you are allergic to clopidogrel, or if you have any active bleeding such as a stomach ulcer or bleeding in the brain (such as from a head injury).

If you have any of these other conditions, you may need a dose adjustment or special tests:

• a bleeding or blood clotting disorder, such as TTP (thrombocytopenic purpura) or hemophilia;

• a history of stroke, including TIA ("mini-stroke");

• a stomach ulcer or ulcerative colitis; or

• kidney disease.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether clopidogrel passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking clopidogrel.

How should I take clopidogrel?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medication with a full glass of water.

Clopidogrel can be taken with or without food.

Because clopidogrel keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using clopidogrel. You may need to stop using the medicine for at least 5 days before having surgery, to prevent excessive bleeding. Follow your doctor's instructions and start taking clopidogrel again as soon as possible. Do not stop using clopidogrel without first talking to your doctor. Use clopidogrel regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medicine is not causing harmful effects, your blood will need to be tested often. Visit your doctor regularly.

Store at room temperature away from moisture and heat.

See also: Plavix dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include vomiting, feeling exhausted or short of breath, and blood in your stools or vomit.

What should I avoid while taking clopidogrel?

While you are taking clopidogrel, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.

Clopidogrel side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using clopidogrel and call your doctor at once if you have any of these serious side effects:

• nosebleed or other bleeding that will not stop;

• bloody or tarry stools, blood in your urine;

• coughing up blood or vomit that looks like coffee grounds;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, problems with vision, speech, or balance;

• pale skin, weakness, fever, or jaundice (yellowing of the skin or eyes); or

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Less serious side effects may include itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Plavix side effects (in more detail)

What other drugs will affect clopidogrel?

Tell your doctor about all other medicines you use to prevent blood clots, including:

• abciximab (ReoPro);

• dalteparin (Fragmin);

• drotrecogin alfa (Xigris);

• enoxaparin (Lovenox);

• eptifibatide (Integrilin);

• fondaparinux (Arixtra);

• heparin;

• ticlopidine (Ticlid);

• tinzaparin (Innohep);

• tirofiban (Aggrastat);

• urokinase (Abbokinase); and

• warfarin (Coumadin, Jantoven).

Tell your doctor about all other medicines you use, especially:

• armodafanil (NuVigil) or modafanil (Provigil);

• fluoxetine (Prozac) or fluvoxamine (Luvox);

• gemfibrozil (Lopid);

• isoniazid (Rifamate, Rifater);

• a cancer medication such as dasatinib (Sprycel), letrozole (Femara), ibritumomab (Zevalin), or tositumomab (Bexxar);

• certain stomach acid reducers, such as cimetidine (Tagamet), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Prilosec OTC, Zegerid), pantoprazole (Protonix), or rabeprazole (AcipHex);

• an antifungal medication such as fluconazole (Diflucan), ketoconazole (Nizoral), or voriconazole (Vfend);

• HIV medications such as delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), etravirine (Intelence), or tipranavir (Aptivus); or

• seizure medication such as felbamate (Felbatol) or oxcarbazepine (Trileptal).

This list is not complete and other drugs may interact with clopidogrel. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about clopidogrel.